Healthcare Provider Details

I. General information

NPI: 1386794634
Provider Name (Legal Business Name): PELLA REGIONAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 03/14/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 JEFFERSON ST
PELLA IA
50219-1257
US

IV. Provider business mailing address

404 JEFFERSON ST
PELLA IA
50219-1257
US

V. Phone/Fax

Practice location:
  • Phone: 641-628-3150
  • Fax:
Mailing address:
  • Phone: 641-628-3150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: GEORGE PAPINEAU
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 641-628-6616